Your vagina is not dirty, and it does not need to be cleaned. This is what a professor of mine used to stress in her gynecology class. What she meant by this was you do not need to douche or use feminine pH balancing washes to “clean” your vagina. In fact, these can actually be harmful to your vaginal health and impact your chances of getting pregnant. Why, you may ask. The answer is bacteria!
More and more we are learning just how important bacteria are to our health. You may have heard words like microbiome or flora. These are just fancy words for the bacteria that live in and on our bodies. In this microbiome, we have bacteria that can promote health, as well as bacteria that can support illness. But more than just “good” and “bad” bacteria, is the way the different species interact with each other, and the environment that interaction creates. Many are aware of the importance of bacteria in the gut, but fewer are aware of the role vaginal bacteria play in health and fertility. Allow me to explain.
The Vaginal Microbiome And Fertility
The vagina houses A LOT of bacteria. There have been studies that have examined what kinds of bacteria lead to better vaginal health, and while there are some variations in the population, generally a microbiome dominated by the species Lactobacillus is the most beneficial. This particular species of bacteria is responsible for maintaining the acidic pH of the vagina (~4.5-4.7) by producing lactic acid and hydrogen peroxide. This acidic environment helps keep other, less beneficial bacteria at bay. Loss of Lactobacillus causes an increase in pH and can lead to vaginal infections, such as bacterial vaginosis (BV). If you are trying to become pregnant this is important because studies have found that those diagnosed with tubal infertility had higher incidences of BV (van Oostrum et al., 2013) and that BV is associated with a higher risk of preclinical pregnancy loss (DiGiulio et al., 2015). While this does not show that BV causes infertility or pregnancy loss, it is definitely something to pay attention to. There have also been studies showing that the vaginal microbiome is important for those undergoing IVF and that a healthier vaginal microbiome can lead to increased live-birth rates (Moore, et al., 2000).
Do’s and Don’ts Of Vaginal Health And Trying to Get Pregnant
Now that the importance of bacteria is clear, let’s discuss what you should and should not do in order to support a healthy vaginal microbiome.
DO – Seek help for chronic or recurring vaginal infections
If you experience chronic or recurring vaginal itching, abnormal discharge or pain, speak with your doctor. These can be signs of vaginal infections, and as mentioned above, if they are chronic or recurring it could be a sign of a less than ideal vaginal microbiome. You can seek care from a naturopathic doctor if you are interested in addressing the cause and creating a healthier, more fertile microbiome.
DON’T – Use douches or vaginal pH balancing washes
While you may think that using these will leave you feeling and smelling fresh and clean down there, these products can end up doing the exact opposite. Douching can literally wash the bacteria – beneficial and non-beneficial – right out of your vagina, and pH altering washes can disrupt the delicate balance needed to maintain a healthy microbiome. This disruption can lead to infections like BV, whose key characteristic is a fishy vaginal odor. Quite the opposite of what you were going for. As mentioned before, BV may decrease your chance of getting pregnant.
DO – Understand your menstrual cycle and hormones
Hormones play a huge role in fertility and supporting healthy vaginal bacteria, and one of the best ways you can understand your hormones is to track your menstrual cycles. Estrogen supports the vaginal lining (also called the epithelium) and glycogen production in those cells. Progesterone causes the release of the glycogen; which Lactobacillus bacteria then use to support a healthy vaginal pH. If these hormones are out of balance, you will likely see some irregularity in your cycles. Signs you’re your hormones are out of balance include, menstrual cycle irregularities, difficulty getting pregnant, chronic or recurring vaginal infections, fibroids, acne or hair growth on face, chest or back. If you notice any of these signs, healthcare provides, especially natural healthcare providers like naturopathic doctors or women’s health acupuncturists, can help you balance your hormones and increases your chances of getting pregnant.
DON’T – Smoke!
If you needed one more reason to quit smoking, here you go. It has been found that smoking negatively impacts the vaginal microbiome, which as stated before, can lead to vaginal infections and difficulty getting pregnant. If you need help quitting you can call 1-800-QUIT for free help.
DO – Consume pre and probiotics
It might be surprising to learn that you can improve your vaginal bacteria by improving your gut bacteria, which is pretty awesome! Consuming foods that support this microbiome is important. Prebiotics act as food for the bacteria in your gut, while probiotics actually provide bacteria that colonize in your gut. Fermented foods like sauerkraut, miso, kombucha and high fiber foods act as prebiotics, while foods like yogurt act as probiotics. If you want more target probiotics, your naturopathic doctor can help recommend some products specifically targeted towards improving vaginal health and increasing your chances of getting pregnant.
DON’T – Take antibiotics unless prescribed by a physician
Antibiotics do a great job of fighting off bacterial infections. Unfortunately, they don’t do a great job of discerning between good and bad bacteria, which means they kill off your healthy bacteria as well. This is the reason gastrointestinal discomfort is the main side effect people experience when taking an antibiotic. It shouldn’t be surprising then that antibiotics can lead to vaginal infections. If you are prescribed antibiotics by a physician, be sure to finish the whole course, and talk to your naturopathic doctor about supplementing with a probiotic to ensure your vaginal microbiome is not disrupted.
In conclusion, your vaginal health and microbiome are connected to your fertility. There are many things you and your doctor can do to support a healthy, fertile vaginal microbiome. And, say with me, your vagina is not dirty, and it doesn’t need to be cleaned!
About the Author: Dr. Nicole Largent, ND
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